Wang Yinmin, Ding Feixue, Shan Shengzhou, Gu Chuan, Yu Wenjie, Yu Shun, Yang Jun
Department of plastic and reconstructive surgery, Shanghai Ninth People's Hospital, School of Medicine, Shanghai Jiao Tong University, 639 Zhi Zao Ju Road, Shanghai, 200011, China.
Shang Shi Aesthetic Medicine, Shanghai, China.
Aesthetic Plast Surg. 2025 Jul 21. doi: 10.1007/s00266-025-05051-z.
The epicanthal fold affects the aesthetic outcome of blepharoplasty in Asians. Thus, blepharoplasty in scenarios with an unmatched epicanthal fold and double eyelid may lead to unsatisfactory results. Restoring the medial canthal region to harmonize with the double eyelid is vital for achieving an upper-eyelid appearance.
In this study, sixteen patients who underwent epicanthoplasty from 2019 to 2023 with a history of unsatisfactory blepharoplasty and an unmatched epicanthal fold were included in this study. The epicanthoplasty was performed based on a four-point homologous design, and the palpebral fissure length (PFL), interepicanthal distance (IED), canthal tilt angle (CTA), and distance from the medial canthus to the beginning of the double-eyelid fold distance (CFD) were recorded preoperatively and 6 months postoperatively.
In all patients, complete surgical healing was achieved within 2 weeks. The CTA, IED, and CFD significantly decreased after surgical treatment, and PFL increased during the 6-month follow-up. Most patients were satisfied with the results during long-term follow-ups.
The epicanthoplasty modification described in this study improved the morphology of the upper eyelid, offering stable outcomes and simpler procedures. Further, we described a decision-making strategy for revisional blepharoplasty. This strategy might be an ideal reparative option for patients with unsatisfactory out-fold type double eyelids and the epicanthus not coordinating with the double eyelid, providing a promising alternative for unsatisfactory blepharoplasty.
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内眦赘皮影响亚洲人双眼皮手术的美学效果。因此，在内眦赘皮与双眼皮不匹配的情况下进行双眼皮手术可能会导致不理想的结果。恢复内眦区域以与双眼皮协调一致对于获得理想的上睑外观至关重要。
本研究纳入了2019年至2023年期间接受内眦成形术的16例患者，这些患者既往有双眼皮手术效果不佳且内眦赘皮与双眼皮不匹配的病史。内眦成形术基于四点同源设计进行，术前及术后6个月记录睑裂长度（PFL）、内眦间距（IED）、眦倾斜角（CTA）以及从内眦到双眼皮褶皱起始处的距离（CFD）。
所有患者均在2周内实现完全手术愈合。手术治疗后CTA、IED和CFD显著降低，PFL在6个月随访期间增加。大多数患者在长期随访中对结果满意。
本研究中描述的内眦成形术改良改善了上睑形态，提供了稳定的效果和更简单的手术方法。此外，我们描述了一种双眼皮修复手术的决策策略。该策略可能是外折型双眼皮效果不佳且内眦赘皮与双眼皮不协调患者的理想修复选择，为不满意的双眼皮手术提供了有前景的替代方案。
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